Impact of HIV-1infection on survival in patients with haematological malignancies in Yaoundeé, Cameroon.

The impact of HIV-1 infection on the survival of patients with haematological cancers in Yaoundeé, Cameroon, was examined. The prevalence of HIV-1 was 26.2% among 172 patients, predominantly lymphoid malignancies. At the time of analysis, 75% of patients had died giving an incidence rate of 0.05 deaths per year and a median of survival of 15 (6-27) months. However, the hazard ratio for HIV-infected patients to die was not statistically different from that of uninfected patients (1.3, 95% confidence interval: 0.9-2.0).

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon.

OBJECTIVES: To evaluate and compare physical activity patterns of urban and rural dwellers in Cameroon, and study their relationship with obesity, diabetes and hypertension. METHODS: We studied 2465 subjects aged >or=15 y, recruited on the basis of a random sampling of households, of whom 1183 were urban dwellers from Yaoundé, the capital city of Cameroon and 1282 rural subjects from Bafut, a village of western Cameroon. They all had an interviewer-administered questionnaire for the assessment of their physical activity and anthropometric measurements, blood pressure and fasting blood glucose determination. The procedure was satisfactorily completed in 2325 (94.3%) subjects. Prevalences were age-adjusted and subjects compared according to their region, sex and age group. RESULTS: Obesity was diagnosed in 17.1 and 3.0% urban and rural women, respectively (P<0.001), and in 5.4 vs 1.2% urban and rural men, respectively (P<0.001). The prevalence of hypertension was significantly higher in urban vs rural dwellers (11.4 vs 6.6% and 17.6 vs 9.1% in women and men, respectively; P<0.001). Diabetes was more prevalent in urban compared to rural women (P<0.05), but not men. Urban subjects were characterized by lower physical activity (P<0.001), light occupation, high prevalence of multiple occupations, and reduced walking and cycling time compared to rural subjects. Univariate analysis showed significant associations between both physical inactivity and obesity and high blood pressure. The relationship of physical inactivity with hypertension and obesity were independent in both urban and rural men, but not in women. Body mass index, blood pressure and glycaemia were higher in the first compared with the fourth quartiles of energy expenditure. CONCLUSION: Obesity, diabetes and hypertension prevalence is higher in urban compared to rural dwellers in the populations studied. Physical activity is significantly lower and differs in pattern in urban subjects compared to rural. Physical inactivity is associated with these diseases, although not always significant in women.

HIV-1 infection in adults with haematological malignancies in Yaoundé, Cameroon.

To determine the association between haematological malignancies and the HIV-1 in Yaoundé, Cameroon, adult patients (> 16 years) followed up in the Haematology Clinics of two major hospitals were screened for the HIV between 1994 and 1999. There were nine haematological malignancies diagnosed among the 172 patients including Non Hodgkin's lymphomas (31.9%); chronic lymhocytic leukaemia (21.5%); chronic myelogeneous leukaemia (18.0%); acute myelogeneous leukaemia (9.9%); acute lymphoblastic leukaemia (7.6%) and multiple myeloma (7.0%). Burkitt's lymphoma, Hodgkin's disease and myelodysplastic syndrome were less frequently diagnosed. Forty-five of all cases (26.2%) had antibodies to the HIV-1 virus, predominantly in patients with Non-Hodgkin's lymphomas (p < 0,001, OR = 5.8, adjusted for age; CI = 2.7 - 12.4). About 19.4% and 11.8% of cases with chronic and acute myelogenous leukaemia respectively were HIV-1 positive. Although B-lineage-derived malignancies are more often associated with the HIV infection, other malignant proliferations of the haematopoietic system may not be coincidental.

Knowledge, attitudes and practices of nursing staff in a rural hospital of Cameroon: how much does the health care provider know about the human immunodeficiency virus/acquired immune deficiency syndrome?

Qualitative and quantitative approaches were used in a rural hospital of Cameroon to assess how much nursing personnel know about and practise in regard to human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and to determine health service factors that influence knowledge, attitudes and practices (KAP). Participants included 107 nursing and laboratory staff and 62 patients with AIDS. Self-administered questionnaires were used for nurses, and close-ended questionnaires were administered to patients with AIDS (as a verification tool for staff responses). Focus group discussions (FGD) held with nurse supervisors evaluated health service factors that influence KAP. Overall, 70.1% of the nurses who responded scored highly in the knowledge section compared to 50.5% in the attitude and practice section. There were several outstanding misconceptions and malpractices about HIV/AIDS. Knowledge, but not attitude, was significantly influenced by the grade of the staff (P< 0.001 and P = 0.17, respectively). Approximately 15% of 62 patients with AIDS indicated that they were attended to with signs of disgust and/or hatred. The major health service factors thought to influence KAP, confirmed by many in all the FGD, included: the lack of adequate information; the lack of commitment to alter attitudes and practices; the lack of in-service promotions; and the ongoing fear of becoming infected with the virus through caring for patients with AIDS. Low income also seemed to have an influence on KAP. Therefore, it is imperative that ongoing education programmes are provided for nurses to enable them to meet the needs of the increasing HIV prevalence in our community. Information, education and communication, and compliance with international working norms, remain essential tools in the control of HIV/AIDS spread in our hospital settings.

The prevalence of hypertension in rural and urban Cameroon.

BACKGROUND: The quickening pace of change and adoption of western lifestyles by people in developing countries has led to a sharp rise in the incidence of hypertension. Yet epidemiological studies using validated methods are rare especially in Central Africa. METHODS: The prevalence of hypertension, according to the World Health Organization definition (systolic blood pressure [SBP] > or = 160, diastolic [DBP] > or = 95 mmHg), was estimated by a population-based survey in 1798 Cameroonian subjects aged 25-74 years. There were 746 individuals from a rural area (308 men, 438 women) and 1052 (461 men, 591 women) from an urban area. RESULTS: The response rate was 95% and 91% for the rural and urban populations respectively. The age-standardized prevalence of hypertension was significantly higher in the urban than in the rural area. It was 16.4% (95% CI: 11.6-21.2) in urban men and 12.1% (95% CI: 7.9-16.2) in urban women, while it was 5.4% (95% CI: 2.9-8.0) in rural men and 5.9% (95% CI: 3.8-8.0) in women. Borderline hypertension (SBP 140-160, DBP 90-95 mmHg) was detected in 7.4% (95% CI: 4.4-10.4) and 6.6% (3.1-10.2) of urban, and 7.3% (95% CI: 4.7-9.9) and 2.9% (95% CI: 1.5-4.4) of rural men and women respectively. CONCLUSIONS: These results indicate that hypertension is still uncommon in rural Cameroon but occurs frequently in the urban community, reaching a proportion comparable with industrialized urban communities.